Hematologic Oncology

There is building evidence that novel combination therapies could be effective in treating early relapsed multiple myeloma.

Genomic sequencing is a critical step in informing the prognosis of patients with acute lymphoblastic leukemia and more information regarding specific subgroups of ALL, such as lineage ambiguous ALL, could pave the way for more personalized therapies for patients.

Although it is too soon to tell whether the addition of a CD20-directed antibody to novel agents in relapsed/refractory follicular lymphoma should become standard practice, it is clear that immunotherapy could represent the next paradigm shift.

With an increased understanding of disease biology, several approaches are under examination to optimize the management of patients with graft-versus-host disease.

Health Canada has approved the BTK inhibitor zanubrutinib for the treatment of adult patients with Waldenström macroglobulinemia.

Christopher R. D’Angelo, MD, discusses sequencing therapies for patients with lymphoma.

Minimal residual disease has helped to predict relapse in numerous leukemia subtypes, with novel testing methods helping to identify the biomarker at a higher sensitivity than ever before.

The treatment landscape of Waldenström macroglobulinemia is becoming increasingly complex with second-generation BTK inhibitors; however, the combination of bendamustine and rituximab remains the frontline standard of care for this patient population.

As more options emerge in the mantle cell lymphoma paradigm, choosing among the agents available has become all the more challenging.

Immune therapy has evolved rapidly in multiple myeloma, and the field is on the verge of major improvements in outcomes.

Although scientific advances in hematology and oncology have been extraordinary, the US health care system faces significant challenges in ensuring that patients receive high-quality, cost-effective care.

Drs Caron A. Jacobson and Krish Patel comment on NGS (next-generation sequencing) and MRD (minimal residual disease) testing in relapsed/refractory follicular lymphoma.

The rationale for rebiopsying patients who have relapsed/refractory follicular lymphoma and the types of molecular information that can be applied to treatment decisions.

Several options have emerged for patients with acute myeloid leukemia who are not candidates to receive chemotherapy, with venetoclax-based regimens chief among them.

Targeted therapies have helped to improve responses in patients with relapsed chronic lymphocytic leukemia regardless of high-risk disease, although optimal sequencing and toxicity management need to be further explored to strengthen the utilization of these options.

The FDA has approved melphalan flufenamide for use in combination with dexamethasone in the treatment of select adult patients with relapsed/refractory multiple myeloma.

Natural killer cells can offer several advantages over T cells for CAR therapy in that the former uses both a CAR dependent and independent mechanism for tumor eradication, has better safety, and off-the-shelf feasibility—all at a potentially lower cost.

High-dose chemotherapy and transplant remains the second-line standard of care for the majority of patients with relapsed/refractory diffuse large B-cell lymphoma; however, CAR T-cell therapy and other novel agents, which have transformed the third-line setting, may offer alternative and more personalized second-line options in the coming years.

Rituximab plus CHOP is not a suitable frontline treatment regimen for all patients with diffuse large B-cell lymphoma, explained Andre H. Goy, MD, who specified that patients with a high-risk International Prognostic Index, elderly patients, and patients with high-risk molecular subtypes require alternative treatment.

Kerry A, Rogers, MD, discusses the rationale behind the phase 1b study of VAY736 combined with ibrutinib in patients with chronic lymphocytic leukemia and the next steps for this research.

Mark Walters, MD, discusses the safety profile of betibeglogene autotemcel gene therapy in pediatric patients with transfusion-dependent β-thalassemia, as reported in the phase 3 Northstar-2 and Northstar-3 trials.

Jorge E. Cortes, MD, discusses future directions in the research of CPX-351 in patients with acute myeloid leukemia.

Srdan Verstovsek, MD, PhD, provides an overview of the similarities and differences between myeloproliferative neoplasms, including polycythemia vera, myelofibrosis, and essential thrombocythemia.